The BIDMC medicine program is fortunate to be affiliated with the West Roxbury VA (West Rox), a large tertiary inpatient medical center that serves veterans throughout New England. West Rox serves as a regional referral center for interventional cardiology, specialized surgery (including open heart, plastics, vascular, and hand surgery), and spinal cord care. It has a MICU, CCU, SICU and progressive care unit.
The VA is a strength of our program, as it allows residents the opportunity to care for a unique patient population and to work with other residents in the Boston area. Residents at West Rox work on the general medical wards and on nightfloat with housestaff from BIDMC, Boston Medical Center, and Brigham and Women's Hospital, providing them the opportunity to learn different practice styles and meet new people. Most interns and residents are at the VA for one ward rotation every year. Residents also spend 1-2 weeks annually admitting patients on VA nightfloat.
The General Medicine rotation is a great mix of both bread and butter cases (COPD, renal failure, end-stage liver disease, GI bleeds) and many obscure/advanced presentations of disease! Based on the comorbidities of the veteran population, residents will have the opportunity to manage patients with spinal cord injury, new oncologic diagnoses, and many other service-connected disabilities. Morning report and noon conference occur daily, and chief residents even throw weekly barbeques in the summertime. In place of noon conference one day a week, residents have a specific "VA curriculum" to enhance knowledge pertinent to the veteran population. Generally, housestaff have more autonomy and procedural opportunities at the VA.
BIDMC junior and senior residents will rotate through nightfloat at the VA for one to two weeks at a time. The nightfloat resident will work on a team with a Brigham and Women's resident to admit patients to the medical and cardiology services. For half of the rotation, the resident will also cross-cover patients in the CCU. An attending nocturnist is in house overnight to cross-cover all general medical wards patients and supervise residents if needed.
All together, the West Roxbury VA offers much to our training program. The patients are grateful for their care and the learning opportunities are abundant.